Alakeel Ahmed, Mubarah Alanoud, Alshehri Mohammed, Alsannaa Feras
General Surgery Senior Registrar, Surgery Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
General Surgery Senior Registrar, Ministry of Health, Riyadh First Health Cluster, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2025 Jul;132:111488. doi: 10.1016/j.ijscr.2025.111488. Epub 2025 Jun 9.
Appendiceal mucocele is a rare condition characterized by the accumulation of mucus within the appendix. It often presents with vague and non-specific symptoms, making its diagnosis and management challenging. The serious complication of this condition is pseudomyxoma peritonei, which can occur if the mucocele ruptures and disseminates mucus throughout the abdominal cavity.
In this case, a 37-year-old woman presented with nonspecific abdominal pain, leading to the incidental discovery of an appendiceal mucocele during a diagnostic workup. The patient underwent a successful laparoscopic appendectomy combined with partial cecectomy, and her post-operative recovery was uneventful.
The surgical management of appendiceal mucocele is still controversial. The aim is to avoid rupture, which can cause peritoneal dissemination and the development of pseudomyxoma peritonei. Depending on the extent of the mucocele and the presence of malignant features, treatment can range from simple appendectomy to more extensive procedures such as right hemicolectomy (Gopalan et al., 2024 [4]). Laparoscopic surgery, though minimally invasive, requires meticulous handling to avoid spillage of the mucocele's contents.
Given the potential complications, appendiceal mucocele should be included in the differential diagnosis once more common causes of abdominal pain are excluded. Early and accurate preoperative diagnosis is critical for guiding surgical management, as it helps prevent rupture and ensures the selection of the most appropriate surgical approach, minimizing the risk of further complications.
阑尾黏液囊肿是一种罕见病症,其特征为阑尾内黏液积聚。它常常表现出模糊且非特异性的症状,这使得其诊断与治疗颇具挑战性。该病症的严重并发症是腹膜假黏液瘤,如果黏液囊肿破裂并使黏液播散至整个腹腔,就可能发生这种情况。
在本病例中,一名37岁女性因非特异性腹痛就诊,在诊断性检查过程中偶然发现阑尾黏液囊肿。患者接受了成功的腹腔镜阑尾切除术联合部分盲肠切除术,术后恢复顺利。
阑尾黏液囊肿的手术治疗仍存在争议。目的是避免破裂,因为破裂会导致腹膜播散和腹膜假黏液瘤的发生。根据黏液囊肿的范围和是否存在恶性特征,治疗方法可以从单纯阑尾切除术到更广泛的手术,如右半结肠切除术(戈帕兰等人,2024 [4])。腹腔镜手术虽然是微创手术,但需要精细操作以避免黏液囊肿内容物溢出。
鉴于潜在的并发症,在排除更常见的腹痛原因后,阑尾黏液囊肿应纳入鉴别诊断。早期准确的术前诊断对于指导手术治疗至关重要,因为它有助于防止破裂并确保选择最合适的手术方法,将进一步并发症的风险降至最低。